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CT versus MR guidance for radiofrequency ablation in patients with colorectal liver metastases: a 10-year follow-up favors MR guidance

  • Hepatobiliary-Pancreas
  • Published:
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Abstract

Objectives

To compare the results of CT- vs MR-guided radiofrequency ablation (RFA) of liver metastases (LM) from colorectal cancer after 10 years of follow-up in an observational, retrospective, and multicentric study.

Methods

A total of 238 patients with 496 LM were treated with RFA either with CT (CT group) or magnetic resonance (MR group) guidance. Every ablated LM was assessed and followed up with diagnostic MRI. Technical success, technique efficacy, predictive factors, recurrence rates, and overall survival were assessed.

Results

The CT group comprised 143 patients and the MR group 77 patients. Eighteen patients underwent ablation with both modalities. Technical success per patient and per lesion was 88% and 93% for CT and 87% and 89.6% for MR, and technique efficacy was 97.1% and 98.6% for CT and 98.7% and 99.3% for MR respectively. Local recurrence following the first ablation (primary patency) occurred in 20.1% (CT) vs 4.6% (MR) (p < 0.001). Residual liver tumor, size of LM, and advanced N and M stage at initial diagnosis were independent predictors for overall survival in both groups. The median overall survival measured from first RFA treatment was 2.6 years. The 1-year, 5-year, and 10-year survival were 85.9%, 25.5%, and 19.1% respectively.

Conclusions

The MR group had significantly better local control compared to the CT group. There was no significant difference in patient survival between the two groups.

Clinical relevance statement

MR-guided radiofrequency ablation of colorectal liver metastases is safe and effective, and offers better local control than CT-guided ablation.

Key Points

• Imaging modality for radiofrequency ablation guidance is an independent predictor of local recurrence in colorectal liver metastases.

• MR-guided radiofrequency ablation achieved better local control of liver metastases from colorectal cancer than CT-guided.

• The number and size of liver metastases are, among others, independent predictors of survival. Radiofrequency ablation with MR guidance improved clinical outcome but does not affect survival.

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Abbreviations

CI:

Confidence interval

CRC:

Colorectal cancer

CT:

Computed tomography

HR:

Hazard ratio

LM:

Liver metastases

LRec:

Local recurrence

LRecFS:

Local recurrence-free survival

M:

Metastases (TNM)

mOS:

Median overall survival

MR(I):

Magnetic resonance (imaging)

N:

Lymph nodes (TNM)

ORec:

Overall recurrence

ORecFS:

Overall recurrence-free survival

OS:

Overall survival

RF(A):

Radiofrequency (ablation)

SD:

Standard deviation

T:

Tumor (TNM)

T1-w:

T1-weighted

T2-w:

T2-weighted

TNM:

TNM staging

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Acknowledgements

The authors wish to express their appreciation to Robert Bauer for his editorial contribution to this manuscript.

Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Center for Radiology, Minimally-Invasive Therapies and Nuclear Medicine, SLK Kliniken GmbH Heilbronn, Heilbronn, Germany

    Philippe Lucien Pereira

  2. Danube Private University (DPU), Krems, Austria

    Philippe Lucien Pereira

  3. Radiology Department, Alexandra General Hospital, Athens, Greece

    Panagiota Siemou

  4. Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University of Tübingen, Tübingen, Germany

    Hans-Jörg Rempp, Rüdiger Hoffmann & Stephan Clasen

  5. Institute and Policlinic for Diagnostic and Interventional Radiology, Carl-Gustav Carus University of Dresden, Dresden, Germany

    Ralf Thorsten Hoffmann

  6. Institute for Diagnostic and Interventional Radiology and Nuclear Medicine, Wiener Neustadt, Austria

    Joachim Kettenbach

  7. Clinic for Radiology, Neuroradiology and Nuclear Medicine Bogenhausen, Munich, Germany

    Thomas Helmberger

Authors
  1. Philippe Lucien Pereira
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  2. Panagiota Siemou
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  3. Hans-Jörg Rempp
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  4. Rüdiger Hoffmann
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  7. Stephan Clasen
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Corresponding author

Correspondence to Philippe Lucien Pereira.

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Guarantor

The scientific guarantor of this publication is Philippe L Pereira, Chairman of the Center for Radiology, Minimally-Invasive Therapies and Nuclear Medicine, SLK-Kliniken GmbH Heilbronn, Germany.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Chara Tzavara MSc, PhD, biostatistician, medical researcher, University of Athens, Greece, kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was not required because the therapies were part of the multidisciplinary clinical management.

Study subjects or cohorts overlap

There are no study subjects or cohorts that have been previously reported.

Methodology

• Retrospective

• Observational

• Multicenter study

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Dr. Joachim Kettenbach deceased

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Pereira, P.L., Siemou, P., Rempp, HJ. et al. CT versus MR guidance for radiofrequency ablation in patients with colorectal liver metastases: a 10-year follow-up favors MR guidance. Eur Radiol (2023). https://doi.org/10.1007/s00330-023-10270-6

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